Morphological and structural placental changes in intrauterine growth-restricted fetuses

Objective: to evaluate the structural and developmental abnormalities of villous tissue coming from placentas of fetuses with IUGR. Patients and methods: placental examination of 45 patients with idiopathic IUGR was carried out in accordance with the guidelines of the "Gruppo Italiano di Anatomia Patologica". The diagnosis of IUGR was made on the basis of fetal growth restriction, amniotic fluid reduction and placental US imaging. Results: the placental microscopic examination showed villous alterations tipical of chronic placental ipoperfusion: ischemic villitis, accelerated villous maturity and placental infarctions. There was evidence of enhanced villous capillarization maybe due to a relative hypoxia of maternal intervillous circulating blood in ten placentas. Conclusion: asymmetric idiopathic IUGR seems to be correlated with alterations of angiogenesis in the initial pregnancy steps with resulting chronic placental ipoperfusion in late pregnancy.